HB 198 — HEALTH: Provides relative to Medicaid reimbursement of ambulatory surgical centers for certain procedures (EN +$400,228 GF EX See Note)

HLSENROLLED 26RS-252 REENGROSSED Regular Session HOUSE BILL NO.

198 BY REPRESENTATIVE ECHOLS HEALTH:AND SENATORS BARROW, JACKSON- ANDREWS, AND JENKINS AND REPRESENTATIVE CHASSION AN ACT To enact R.S.

Providesrelative to Medicaid reimbursement ofambulatorysurgicalcentersfor certain procedures AN ACT To enact R.S.

to provide for Medicaid reimbursementrates;toauthorizetheLouisianaDepartmentofHealthtopromulgatereimbursement rules;rates;

to provide for a reimbursement rate plan;

to provide for implementation;toprovideforadeadline;to authorizetheLouisianaDepartmentof Health to promulgate rules;

to provide for implementation;

ReimbursementMedicaid rateambulatory forsurgical ambulatorysurgerycenter centersreimbursement A.plan;

TheMedicare secretaryrate ofcomparability theA.(1) The Louisiana Department of Health shall takedevelop alland necessaryimplement actionsa toplan establishfor aincreased Medicaid managed care organization reimbursement raterates whichand isfee-for-service thereimbursement lesserrates offor theratepaidingastroenterology, andental outpatienthospitalsettingoronehundredpercentoftheMedicareophthalmology, rateforgastroenterology,ophthalmology,andotolaryngologyproceduresconducteddental atand ambulatoryotolaryngology surgeryprocedures conducted at ambulatorysurgical centers.

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HB NO.

198 ENROLLED (2) The reimbursement rate established pursuant to this Section shall be the lesser of the following:

(a) The rate paid for the same or similar procedure in an outpatienthospital setting.

(b) One hundred percent of the Medicare rate for the same or similar procedure.

(3) The plan shall include procedure codes utilized for gastroenterology, ophthalmology, dental and otolaryngology procedures conducted at ambulatory surgical centers and the estimated cost of implementation of the plan.

The Louisiana Department of Health shall take all necessary actions to annually update the reimbursement raterates for gastroenterology, dental, ophthalmology, and otolaryngology procedures conducted byat ambulatory surgerysurgical centers annually in accordance with the methodology describedprovided in Subsection A.A of this Section.

C.C.TheLouisianaDepartmentofHealthshallsubmittheplanrequiredbythis Section to the Senate Committee on Health and Welfare, the Senate Committee on Finance,theHouseCommitteeonHealthandWelfare,andtheHouseCommitteeon Appropriations no later than October 1, 2026.

TheD. Louisiana Department of Health shall promulgate all rules and regulations inaccordancewith theAdministrative ProcedureActasarenecessaryto implement the provisions of this Section.

Section2.Not later than October1, 2026, the Louisiana Department of Health shall takeallnecessaryactions,includingbut not limited to filinganyMedicaidstateplan amendment required by the Centers for Medicare and Medicaid Services, to implement the provisions of this Section.

E.

The Louisiana Department of Health shall promulgate all rules and regulationsin accordancewith theAdministrative ProcedureActasarenecessaryto implement the provisions of this Section.

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The implementation of the provisions of this Act shall be subject to the appropriation of funds by the legislature for this purpose.

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HLS 26RS-252 REENGROSSED HB NO.

198 ENROLLED Section 3.4.

This Act shall become effectiveuponeffective upon signature bythe governor or, if not signedbythegovernor,uponexpirationofthetimeforbillstobecomelawwithoutsignature by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana.

If vetoed bythe governorand subsequentlyapprovedbythesubsequentlyapproved bythe legislature, this Act shall become effective on the dayfollowing such approval.

DIGESTSPEAKER ThedigestprintedbelowwaspreparedbyHouseLegislativeOF Services.THE HOUSE OF REPRESENTATIVES PRESIDENT OF THE SENATE GOVERNOR OF THE STATE OF LOUISIANA APPROVED:

ItPage constitutes3 nopart of the3 legislativeCODING: instrument.

The keyword, one-liner, abstract, and digest do not constitute part of the law or proof or indicia of legislative intent.

[R.S.

1:13(B) and 24:177(E)] HB 198 Reengrossed 2026 Regular Session Echols Abstract:

Provides for Medicaid reimbursement for certain gastroenterology, otolaryngology, and ophthalmology procedures performed in ambulatory surgery centers.

Proposed law requires the secretary of the La.

Dept.

of Health (LDH) to take all necessary actionsto implement aplanto reimburse ambulatorysurgerycentersdescribedbyproposed law.

Proposed law provides that gastroenterology, otolaryngology (ear, nose, and throat), and ophthalmology procedures performed at an ambulatory surgery center shall be reimbursed by Medicaid at a rate equal to the rate paid in an outpatient hospital settingor 100% of the Medicare rate, whichever is less.